HomeMy WebLinkAboutBLD2023-00234 - BLD CD Environmental Health Review - 3/3/2023 0.9--;rolit_ t MASON COUNTY COMMUNITY SERVICES Permit No: �+-`- M
• °V sic. , PERMIT ASSISTANCE CENTER: D �u"
.Ft:\, •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
c a_a t. i I 615 W.Alder Street,Shelton,WA 98584 MAR 0 3 2023
i :_f� Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone MAR 01 20
v Belfair:(360)275-4467•Phone EJma:(360)482-5269
`'°')•r,tt.,.t' RECEIVED
BUILDING PERMIT APPLICATION
615 W, Alde reet
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:.
NAME:Pc O partieS VII NAME:} }'►b
MAILING ADDRESS: Igoe SIpS MAILING ADDRESS: l4jpY 5(0
C1TY:gt L STATE:(,Oa ZTP:4I$32Z CITY:g ,y STATE:L04 ZIP:el 322 rn
PHONE#1:3(.0 $ 3235 PHONE: CELL:20(e 22:j SII,
PHONE#2: 10i, 2221 51 in EMAIL: t'1 .ts1.a-te.0 rnspl. C ole Z
EMAIL:►-J rectt`le-S4 -kt_ rrisn•C-GW✓I L&I REG tri2,3c .jiP$(ol bL( EXPO. /261/2.1
PRIMARY CONTACT: OWNER CONTRACTOR 0 OTHER 0 I = _
NAME Ml CIY) Le=�'I���`` EMAIL m 0
MAILING AD ESS V% CITY13 STATE(,Ukl zip qu3Z2
PHONE CELL 2$3 514.3915
74
PARCEL INFORMATION: = m
PARCEL NUMBER(12 Digit Number)l2 33( - S l - 0002-Le ZONING Z
LEGAL DESCRIPTION(Abbrcviatcd)Bt¢{ g Cove_n IV !3 lb I. 2 to FIRE DISTRICT
SITE ADDRESS tot I'lE & pi-&LI'1 k e_[P CITY 1jL(P-Q
D CTIONS TO SITE ADDRESS l ,�t� Art) }- Cryi CrC Q,LJ'i {' ook_('lZ r
Clod C/In b4..
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO iii SNOW LOAD: psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all Ma:apply):
SALTWATER❑ LAKE 0 RIVER/CREEK 0 POND 0 WETLAND 0 SEASONAL RUNOFF❑ STREAM 0
TYPE OF WORK: NEW X ADDITION 0 ALTERATION 0 REPAIR❑ OTHER V
USE OF STRUCTURE(Residence.Garage,Commercial Bldg.Etc.)
IS USE: PRIMARY' SEASONAL 0 NUMBER OF BEDROOMS 2 NUMBER OF BATHROOMS -2.
HEATED STRUCTURE? YES(Whole Bldg)0 YES(Part/s)elBldg)0 NO❑
DESCRIBE WORK
SQUARE FOOTAGE:(prat.,...!)
1ST FLOOR 133'6 sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. Attached 0 Detached 0 CARPORT sq.ft. Attached❑ Detached 0
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE Alec.. )cX3d MODEL Eo..t3L.c. YEAR ?l)Z3 LENGTH 042.I
WIDTH 21ot $It BEDROOMS 3 BATHS 2, SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGEJSEWER SOURCE: SEPTIC SEWER❑ / NEW❑ EXISTING
PLUMBING IN STRUCTURE? YES X NO❑ If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION RAINS PROPOSED? YES 0 NOD EXISTING SQ.FTT
EXISTING BEDROOMS Z PROPOSED BEDROOMS Z— TOTAL BEDROOMS 4,-"-
OWNER acknowledges that submission of inaccurate Information may result in a stop work order or permit revocation.Acknowledgement of such is by
signature below.I declare that I am the owner and I further declare that I am entitled to receive this permit and to do the work as proposed.I have
obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project. The owner or legal
representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property
and structure(s)for review and inspection. This permit/application becomes null&void if work or authorized construction is not cornmerced within 180
days or if construction work is suspended for a period of 180 days.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
a �alaoa3
X\ Slgn re of O ust be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH Kfi /(r j1 i.Cr\6,N(/Is Ca
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PLN Approved
04/20/2023
Mason County Community Development
Gavin Scouten EH Setbacks
All Changes Subjbjectecttto Approval
A.) Drainfield/Reserve requires 10'setback from footing/foundations
Planning Setbacks B.) Septic tank(s) requires 5'setback from all footing/foundations
Front: 25' C.) No foundation/Perimeter Drains within 30ft, downgradient of
Sides: 7' Drainfield/Reserve area
Rear: 20' D.) No Cut Bank(s) (greater than 5ft and over 45 degrees)within
*all setbacks measured from the farthest 50ft,down gradient of Drainfield/Reserve area
projection of the building
`subject to EH setbacks
• EH APPROVED
' Rhonda Thompson 05/08/2023
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